Ethiopia braces to tackle widespread malnutrition

Addis Ababa- Ethiopia (PANA) -- Ethiopia is making a bold move to improve the health of children by wiping out what have been the characteristic indicators of their retarded growth.
Underweight, wasting and stunting could soon remain on record as past inhibitors of mental and physical development of Ethiopian children if proper nutrition is given emphasis from household and community level.
In a historic step to better tackle malnutrition, the health ministry has agreed to adopt and standardise the Protocol on the Management of Acute Malnutrition.
Developed more than a decade ago by world-renowned nutritionists -- Professor Mike Golden and Dr Yvonne Grellety, the life-saving protocol has since been successfully applied in many African countries.
Ethiopia's decision follows a two-day national consultation, held at the weekend between the health ministry and representatives of regional health bureaux, non-governmental organisations and international partners.
These included UNICEF, the World Health Organisation and the World Food Programme who are currently providing blended food to famine victims through NGOs working in areas where acute malnutrition rate is rising.
"With more than half of the children in this country stunted from chronic malnutrition, good nutrition presents an enormous challenge under the best of circumstances," observed Shantha Bloemen, a communication officer at the UNICEF country office.
"But now with the humanitarian situation being further exacerbated by the drought and widespread rural poverty, there has been a dramatic increase in the number of children suffering from acute malnutrition -- a condition from which they can die," Bloemen told PANA.
UNICEF estimates 80,000 children in Ethiopia could be acutely malnourished, with thousands in urgent need of therapeutic feeding.
Little capacity has previously been invested in Ethiopia's health system to understand and treat the complications that can result from this health disorder.
Even when a child is able to get to a health clinic or feeding centre, misdiagnosis and wrong treatment can lead to death, expatriate nutritionists in the country say.
"During this national consultation we have made sure that this protocol is feasible, not just from a scientific perspective but also practically in an Ethiopian context," said Hiwot Mengistu of the family health department that is responsible for nutrition matters in the health ministry.
"It is crucial now that the protocol becomes the practice in treating malnutrition in every health station, clinic, and hospital so that we prevent more children from dying," she said.
Responding to the deteriorating nutritional situation in many parts of Ethiopia early this year, UNICEF realised it needed to strengthen the capability of the health system to cope with this crisis.
It was then that the UN agency for the protection of children recruited the expertise of Golden and Grellety.
The protocol worked out by these experts outlines step by step guidelines for the management of severe malnutrition.
Now operational in 34 therapeutic feeding centres across the country, the protocol is credited with directly reducing child mortality rates and saving lives.
"I applaud this timely decision to adopt and standardise the treatment of acute malnutrition," said WHO Representative Angela Benson.
"Nutrition has been on the backburner for too long.
With the nutritional crisis across the country so serious, it is essential that it should be further integrated into the primary health care system response.
"The protocol will strengthen the Government's ability to improve nutritional surveillance so that we can better respond before too many children are affected.
We must also consider nutrition promotion for mothers and their children so that appropriate food combination is practised at household level to break they cycle of repeated malnutrition and stunted growth," she said.
According to a UNICEF nutritionist working in Ethiopia's Southern Nations, Nationalities and Peoples Region (SNNPR), the secret to the protocol's success is that "it is straight forward and easily understood by health workers.
" Mohammed Foh added: "The protocol presents the formula on how to diagnose and treat this condition in a practical way.
We have witnessed a dramatic change in the way health workers respond to the disease.
They now see this as a battle they can win.
" Illustrating the same point, Prof.
Golden retold a story from his won recent experience when on a visit to a therapeutic feeding centre in SNNPR.
An orthopaedic surgeon in charge of the region told him: "We used to think we were lucky if a malnourished child survived, now we get very angry when a child dies.
" "The whole thinking has changed.
Nurses used to run away from malnutrition cases because they were afraid children would die.
But, now they want to work in that unit.
There has been a complete sea change in the way malnutrition is perceived and thought of in the South," Golden explained.
What does it mean to adopt this nutritional protocol and standardise the treatment of acute malnutrition? UNICEF Ethiopia Representative Bjorn Ljungqvist explains: "We at UNICEF believe the gains for children are enormous.
First, it means that all across the country, we will have a standard response to this disease.
Secondly, it means that all health workers, nurses and doctors in the country will be trained in how to diagnose and treat acute malnutrition.
" Ljungqvist sees adoption of the protocol as a major breakthrough to have treatment of malnutrition as part of the basic health response, whereby every hospital and clinic with trained staff will deal with malnutrition cases instead of waiting for the setting up of a feeding centres for malnourished children.
UNICEF believes that by adopting the protocol, the Ethiopian government has taken a very important step to integrate nutrition into the primary health system.
This initiative takes Ethiopia closer to fulfilling its responsibility to ensure all its children have their right to survival guaranteed.

23 june 2003 10:19:00




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